| Legacy Counseling Services, Llc | |
|
1435 Grand Ave Yazoo City MS 39194-2651 | |
| (662) 532-2399 | |
| Not Available |
| Full Name | Legacy Counseling Services, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1435 Grand Ave, Yazoo City, Mississippi |
| Authorized Official Name and Position | Ouida Parks (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 6625322399 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Counseling Services, Llc Po Box 861 Yazoo City MS 39194-0861 Ph: () - | Legacy Counseling Services, Llc 1435 Grand Ave Yazoo City MS 39194-2651 Ph: (662) 532-2399 |
| NPI Number | 1093326118 |
|---|---|
| Provider Enumeration Date | 08/12/2020 |
| Last Update Date | 09/14/2020 |
| Certification Date | 09/14/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093326118 | NPI | - | NPPES |
| 09958268 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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